Abstract
In this present study ten patients with different types of mandibular fractures were selected from the out patient and inpatient clinics of Oral Surgery Department, Faculty of Dentistry, Alexandria University. A comprehensive screening history. and thorough clinical examination was carried out for all patients including present and past dental and medical history, local and general clinical examination, and radiographic examination of the mandible using panoramic views. The patients were treated under general and local anaesthesia. Treatment was done by reduction and fixation. Reduction was carried out either by closed or open reduction according to the degree of displacement. Mesh-backed arch bar were adapted and fixed to the maxillary and mandibular teeth using light cure composite material in two cases using complete piece arch bar and chemical cure composite material in 8 cases. Among the chemical cure cases, 3 had their fracture reduced and fixed using segmented arch bar while for the remaining 5 cases the used arch bar was in a complete piece. For segmented arch bars, a stainless steel wire was attached on both sides of the fracture line one day after bonding of the arch bar and this wire was reinforced by heavily bonding along the wire for additional stabilization and immobilixation. Maxillomandibular fixation was achieved using elastic bands with an average tensile force of 4.5 inch/min placed on the second post operative day. Routine oral hygiene and feeding instructions as well as prophylactic antibiotic, and analgesics were prescribed for all patients. Six weeks postoperative follow-up was carried out every two days for evaluation of pain, swelling, efficiency of reduction, stability of the arch bar, strength of elastic bands and any other. arising complications. Postoperative panoramic x-ray were taken after 6 weeks to check the alignment of the fracture ends as well as the occlusion and the lower border continuity and healing. The clinical rsults achieved in cases treated with light cure composite were not satisfactory since detachment of the arch bars occured after bonding with light cure and the arch bar was refixed by wires Better results were specially obtained from segmented arch bar where no detachment occured throughout the follow up period while. in the remaining five cases treated using one piece arch bar, 2 cases showed no complications throughout the 6 weeks period, one case came with detached upper arch bar after one week and one case after